Southern Comfort Home Healthcare, LLC

Primary specialty

In Home Supportive Care AgencyTaxonomy code 253Z00000X

Legal business name

SOUTHERN COMFORT HOME HEALTHCARE, LLC

Practice address

1006 Union Rd
Gastonia, NC 28054-0466

Phone

(704) 915-2010

NPI assigned

Jan 16, 2020

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Darriel Fortenberry

Title

Owner

Phone

(704) 915-2010

Specialties & licenses 1

Addresses

Locations

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1579132800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579132800000",
    "number": "1407486525",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2443 BETHESDA OAKS DR",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280560001",
            "telephone_number": "704-915-2010",
            "fax_number": "704-879-9225"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1006 UNION RD",
            "city": "GASTONIA",
            "state": "NC",
            "postal_code": "280540466",
            "telephone_number": "704-915-2010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHERN COMFORT HOME HEALTHCARE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-16",
        "last_updated": "2020-01-16",
        "certification_date": "2020-01-16",
        "status": "A",
        "authorized_official_last_name": "FORTENBERRY",
        "authorized_official_first_name": "DARRIEL",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "704-915-2010"
    },
    "taxonomies": [
        {
            "code": "253Z00000X",
            "taxonomy_group": "",
            "desc": "In Home Supportive Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 16, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.